Active NPI
Nancy Gavenda
- Clinical Child & Adolescent Psychologist
- Danvers, MA
National Provider Identifier
1548774466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- Practice address
- 6 Southside Rd
Danvers, MA 01923-1409 - Phone
- (978) 624-3725
- NPI assigned
- Nov 30, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | Primary |
Addresses
Primary practice location
6 Southside Rd
Danvers, MA 01923-1409
Mailing address
6 Southside Rd
Danvers, MA 01923-1409
Phone (978) 624-3725
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512000000000",
"number": "1548774466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 SOUTHSIDE RD",
"city": "DANVERS",
"state": "MA",
"postal_code": "019231409",
"telephone_number": "978-624-3725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 SOUTHSIDE RD",
"city": "DANVERS",
"state": "MA",
"postal_code": "019231409",
"telephone_number": "978-624-3725"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAVENDA",
"first_name": "NANCY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-30",
"last_updated": "2017-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Danvers, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.